Provider Demographics
NPI:1154420974
Name:DUKE, VIKKI J (AUD)
Entity type:Individual
Prefix:DR
First Name:VIKKI
Middle Name:J
Last Name:DUKE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4564 S HARVARD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2918
Mailing Address - Country:US
Mailing Address - Phone:918-745-9052
Mailing Address - Fax:918-749-9770
Practice Address - Street 1:4564 S HARVARD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2918
Practice Address - Country:US
Practice Address - Phone:918-745-9052
Practice Address - Fax:918-749-9770
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK304231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P33991OtherCOMM CARE
9916232OtherCIGNA
2260654OtherUHC
P33991OtherCOMM CARE